Researchers conducted focus groups and in-depth interviews with women, ages 18-49, who self-identified as Black or African American and lived in Georgia or North Carolina—states specifically chosen for their restrictive reproductive health policies. The majority of participants had employer-based, school, or private insurance.

Experiences of structural and individual racism arose in conversations about contraception, prenatal care, and maternal care—often without prompting. Negative impacts included timely access to care, use of care, experience with care, and interactions with healthcare providers.

The research team’s community-based and participatory approach included local justice advocates leading recruitment and data collection efforts to ensure the study was appropriately designed and results were accurately interpreted and disseminated. Researchers concluded that addressing racism and its impact on Black women’s sexual and reproductive health requires actions taken within the healthcare system coupled with policy actions at the state government level.